‘The polio vaccine is effective, but delivering it requires a ceasefire’

Ruwaida Kamal Amer

August 27, 2024

For 25 years, the Gaza Strip was free of polio. No longer. Earlier this month, the health ministry reported that a 10-month-old baby had contracted the disease; a week later, he was paralyzed. This came after polio virus had been detected in sewage samples from six locations in the cities of Deir Al-Balah and Khan Younis. 

With raw sewage flowing through Gaza’s streets, in close proximity to the tents of displaced people and the few remaining sources of freshwater, a potentially catastrophic epidemic could soon be afoot. A mass vaccination campaign is essential, but so long as Israel’s military offensive continues, such a campaign seems impossible — even as vaccines have started to be brought in. All across the Gaza Strip, Palestinians fear the consequences of the spread of the disease, especially to children who comprise half of the enclave’s population.

“When my children go out to play, we run after them, shouting not to go near the sewage water,” Reem Al-Masry, a 35-year-old mother of three displaced from Beit Hanoun to Deir al-Balah, told +972. “But they are bitten all the time by mosquitoes and flies that live on piles of garbage and sewage and transmit diseases to us. Every day, my children complain of stomach pain, fever, skin rashes, and other health problems.”

For Saeed Samour, 40, who was displaced from Gaza City to Khan Younis, “the presence of sewage around us — and close to the few available water sources — is a scary thing.” In recent weeks, Samour’s 3-year-old son Zaid showed signs of a skin infection, most likely due to the air pollution caused by the remnants of war. “These children need daily bathing,” he said. “But cleaning products are very few and very expensive. One bar of soap, which used to cost only $1, now sells for $4.”

Now, Samour is anxious that Zaid will get sick from exposure to pathogens in the sewage. “There is no area in the city without pools of sewage water, and no one can walk around because of these pools,” he said. “Our food and water needs to be sterilized and cooked several times to be suitable for drinking and eating, and the lack of cooking gas is a major obstacle.”

As Israel’s airstrikes, ground incursions, and evacuation orders continue to terrorize Palestinians throughout the Strip, the so-called “humanitarian zone” along the coast has become one of the most densely populated areas in the world. Adnan Abu Hasna, a spokesperson for the UN Relief and Works Agency (UNRWA), told +972 that 1.8 million Palestinians are crammed into the area extending from the north of Rafah through Deir al-Balah to Nuseirat refugee camp. “There are 60,000 people in every square kilometer, and the displacement process continues,” he added.

Combined with the breakdown in water and sewage infrastructure, this severe overcrowding has led inevitably to the outbreak and transmission of disease. And it’s not just polio that the health authorities are worried about.

“Before October 7, Gaza had 85 cases of hepatitis,” Abu Hasna explained. “Today, we are talking about a thousand cases per week and the number is increasing: about a month ago, we recorded 40,000 cases.” Based on this rapid transmission rate, Abu Hasna warned, “the discovery of the polio virus is a dangerous development, and it will have disastrous consequences.”

‘If our children aren’t killed by missiles, they’ll die from disease’

Just hours before the first case of polio was reported in Gaza, UN Secretary General António Guterres called for an immediate, week long ceasefire — a “polio pause” — to allow for the rollout of a vaccination campaign. The World Health Organization (WHO) declared that it was ready to release 1.6 million doses, with UNRWA medical teams preparing to administer them to more than 640,000 Palestinian children under the age of 10.

Israel quickly began vaccinating its own soldiers against the disease, but waited several before permitting the entry of vaccines for Gazans. Yet even as medical teams seek to inoculate the population, no ceasefire appears forthcoming.

“The oral polio vaccine is effective,” Sameer Sah, the UK director of programmes at Medical Aid for Palestinians (MAP), told +972. “The challenge is in delivering the vaccine in an area where people are being displaced on a near-daily basis, means of transport are difficult to find, roads are damaged, and health services are being attacked.

“Such a campaign would accomplish a lot, but the expansion of the red zone in Gaza [the areas from which Israel has ordered residents to evacuate] makes it difficult to reach every child,” Sah continued. “A complete ceasefire is required to deliver adequate health care, including vaccination not only for polio but also for other preventable diseases.”

In recent days, patients and nurses have been forced to flee Al-Aqsa Martyrs Hospital in Deir Al-Balah as Israeli forces close in. Dr. Khalil Al-Daqran, told +972 before the evacuation that the hospital had been serving approximately 1 million people displaced to Gaza’s central region; the corridors and floors were full of patients due to the lack of empty rooms and beds.

Given these conditions even in the hospitals that remain functional, Al-Daqran was pessimistic about the prospects of combating the spread of polio given the dire state of Gaza’s health care system under Israeli bombardment. “We don’t even have the equipment to test for the epidemic,” he said.

In these circumstances, with other diseases running rampant throughout Gaza, parents are terrified for their children. “As mothers, these illnesses scare us,” Al-Masry, the mother of three, said. “If our children aren’t killed by the missiles, they will die from these strange diseases that appear due to pollution and lack of sanitation.”

‘Israel is using water as a weapon’

At the end of July, a video circulated widely on social media showing Israeli army combat engineers blowing up a water reservoir in the Tel al-Sultan neighborhood of Rafah. The soldier who uploaded the video dedicated the demolition “in honor of Shabbat,” drawing international condemnation, and the army now claims to be investigating the incident.

For Ayman Labad, a researcher at the Palestinian Center for Human Rights’ economic and social rights unit, the obliteration of the reservoir came as no surprise given that Israeli forces have destroyed about 67 percent of the Strip’s water and sanitation facilities over the past 10 months. The only surprise, he said, was that they filmed themselves doing it.

By mid-June, the facilities destroyed in the war included 194 water production wells, 40 large-scale water tanks, 55 sewage pumping stations, 76 municipal desalination plants, four sewage treatment plants, nine spare parts warehouses, and two water quality testing labs. “The meaning of this is clear: Israel is using water as a weapon in its genocide against the population of the Gaza Strip,” Labad argued.

And with the forced closure of these facilities, Gaza’s water sources have become contaminated, leading to the rapid spread of illness. “The residents of the Strip currently live on just one-fifth of the amount of water available before October 7,” Labad stated. “About 66 percent of Gazans are suffering from water-borne diseases such as cholera, chronic diarrhea, gastroenteritis, and hepatitis.”

As sources of clean water have dwindled, Gazans have been forced to queue for hours to obtain what little water is available, and to sacrifice basic hygiene — a critical part of avoiding illness. “Every person needs dozens of liters of water, but we now stand in line and wait for about seven hours just to get two gallons,” Saeed Al-Jabri, a 38-year-old from Rafah, told +972. “Is it reasonable for a person to endure these conditions?”

Like many displaced Palestinians, Al-Jabri has taken to bathing in the sea. “The seawater is salty and when it dries up, the salts settle on the skin and can cause inflammation,” he said.

Al-Jabri has seen the videos of Israeli soldiers targeting water sources, and cannot help but express his anger. “There is no military goal behind it,” he noted. “It’s simply revenge, with civilians being punished.”

 

Israel Is Forcing One of the Last Remaining Hospitals in Gaza to Evacuate

Sharon Zhang

August 26, 2024

Patients, staff and families sheltering in the last remaining hospital in central Gaza are being forcibly displaced as the threat of a raid by Israeli forces looms large and Israel orders evacuations in the areas surrounding the crucial medical facility.

In recent days, Palestinians have been fleeing al-Aqsa Martyrs Hospital as Israel ordered evacuations in nearby neighborhoods of Deir el-Balah previously labeled as part of the “safe zone” last week and on Sunday.

Though the hospital technically isn’t in the evacuation area drawn by Israel, Israeli officials have said that “forces will operate aggressively” in the areas surrounding it. Further, Médecins Sans Frontières (MSF) has reported that Israeli forces struck an area 250 meters away from the hospital, or just over a tenth of a mile, on Sunday, triggering panic.

The hospital is nearly empty now with only a few dozen occupants left, as many have fled on foot, some wheeling patients out in their beds. Over 600 patients were being treated at the hospital before the forced evacuations, and it was acting as a shelter for many families with nowhere left to go.

Patients there have been forced to make an impossible choice: risk death at the hands of the Israeli military or flee and face potential complications from whatever condition landed them in the hospital, likely caused by Israel’s genocide.

“Our fate is to die,” Fatimah al-Attar told Associated Press, fighting back tears while evacuating. “There is no place for us to go. There is no safe place.”

MSF, which helps support the hospital, says that it is “considering whether to suspend wound care for the time being, while trying to maintain life-saving treatment.”

Al-Aqsa was one of only roughly 16 hospitals still partially functional in Gaza as Israel has systematically destroyed the health system across the region. Many of these hospitals are small, able to treat only a few dozen patients at a time; al-Aqsa is one of the largest hospitals that hasn’t been thoroughly destroyed by Israeli forces.

The Israeli military’s raids of hospitals in Gaza over the past 10 months have been horrific. After Israel’s raid of al-Shifa Hospital — previously the largest hospital in Gaza — this spring, Palestinian officials uncovered three mass graves there. In total, over 500 bodies were found buried in seven mass graves discovered in the area after Israel’s assault.

Though Palestinians are evacuating al-Aqsa, there is essentially nowhere left in Gaza for them to go.

The so-called humanitarian zone in Gaza, which Israel has bombed despite labeling it as safe, is at capacity. The “safe” zone only encompasses 11 percent of Gaza’s land, while humanitarian groups estimate 1.9 million people have been forcibly displaced at least once. Aid groups say that the “safe” zone is so crowded that even roads are blocked by tents, making the delivery of humanitarian aid nearly impossible.

“This is a complete stripping of humanity. A never-ending tragedy,” said the UN Relief and Works Agency for Palestine Refugees (UNRWA) of the evacuations. “Families across the Gaza Strip continue to be forced to flee, forced to leave their homes and belongings behind. All they can now do is try to stay alive. People have lost absolutely everything.”

The agency noted that Israel’s assault on Deir el-Balah has significantly reduced the water capacity there, leaving a shortfall of water of 85 percent.

 

UN Forced to Suspend All Operations Across Gaza Due to Israel’s Evacuations

The lives of millions of Palestinians are at risk as the UN has been forced to suspend its operations across all of Gaza after Israel’s mass evacuation orders and violence has made it nearly impossible for humanitarian groups to distribute or even access aid.

The UN’s aid operations “ground to a halt” on Monday after the latest round of evacuations of Deir el-Balah, Reuters reported, citing an anonymous senior UN official. This is the first time that the UN has been forced to suspend all operations across Gaza due to Israel’s genocide.

“We’re unable to deliver today with the conditions that we’re in,” the official said. “We’re trying to balance the need of the population with the need for safety and security of the UN personnel.”

The official stressed that the UN is still committed to staying in Gaza, but that doing so is becoming more and more difficult. The UN’s main operations were in Deir el-Balah and personnel have been forced to leave equipment behind as a result of Israel’s forced evacuation and ground assault, which has already commenced.

 

In recent days, UN groups and other aid organizations have been warning that Israel’s latest evacuation orders have created an impossible situation for Palestinians in Gaza and the humanitarian groups acting as one of Palestinians’ last lifelines there. Israel’s designated “safe zone” — that the Israeli military has attacked many times — is packed with tents, with families erecting shelters all the way up to the shoreline.

Because of how crowded the area is, and because parts of the main aid route are now what Israel has dubbed the “combat zone,” humanitarian groups say that it takes hours to move just a few miles.

Groups say requests to Israeli forces to allow for safe humanitarian movement go ignored for weeks, even as the situation on the ground changes daily; and groups have reported being targeted by Israeli forces even if they are given permission to travel safely. Israel is killing a record number of aid workers and has killed over 200 UN Relief and Works Agency for Palestine Refugees (UNRWA) workers in Gaza just since October; in all, the Israeli military has killed 280 aid workers amid its genocide.

“Where do we move now? … The challenge is to find a place where we can reset and effectively operate,” the UN official said to Reuters. “The space to operate is being restricted more and more than ever.”

UNRWA Director of Planning Sam Rose also echoed the space concerns in a press conference on Monday. “The space and the ability of the UN system, the humanitarian system, to operate in Gaza is becoming increasingly difficult — is becoming increasingly constrained,” Rose said.

UNRWA spokesperson Louise Wateridge added that Israel has issued 16 displacement orders in the past month alone, with five of them issued just between August 19 and 24. This means that the agency, which delivers and coordinates aid across Gaza, and other aid groups have lost access to water wells, warehouses, distribution centers, health centers and other facilities countless times. Multiple times this month, Wateridge said, aid groups have had to evacuate facilities and move equipment due to Israel’s orders.

The UN provides a wide swath of crucial services in Gaza, providing food, medical supplies, health care services, shelter, and more. Though it’s unclear how long the UN suspension will last, even just a temporary halt could be disastrous amid the famine and health crisis.

Israel boasted on Sunday that it has allowed polio vaccine vials to enter Gaza after creating conditions for a polio epidemic in the Gaza Strip. However, the suspension of UN services will mean that most or all of these vaccines won’t actually be able to reach the population.